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Social differences in avoidable mortality between small areas of 15 European cities: an ecological study

BACKGROUND: Health and inequalities in health among inhabitants of European cities are of major importance for European public health and there is great interest in how different health care systems in Europe perform in the reduction of health inequalities. However, evidence on the spatial distribut...

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Autores principales: Hoffmann, Rasmus, Borsboom, Gerard, Saez, Marc, Mari Dell’Olmo, Marc, Burström, Bo, Corman, Diana, Costa, Claudia, Deboosere, Patrick, Domínguez-Berjón, M Felicitas, Dzúrová, Dagmar, Gandarillas, Ana, Gotsens, Mercè, Kovács, Katalin, Mackenbach, Johan, Martikainen, Pekka, Maynou, Laia, Morrison, Joana, Palència, Laia, Pérez, Gloria, Pikhart, Hynek, Rodríguez-Sanz, Maica, Santana, Paula, Saurina, Carme, Tarkiainen, Lasse, Borrell, Carme
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007807/
https://www.ncbi.nlm.nih.gov/pubmed/24618273
http://dx.doi.org/10.1186/1476-072X-13-8
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author Hoffmann, Rasmus
Borsboom, Gerard
Saez, Marc
Mari Dell’Olmo, Marc
Burström, Bo
Corman, Diana
Costa, Claudia
Deboosere, Patrick
Domínguez-Berjón, M Felicitas
Dzúrová, Dagmar
Gandarillas, Ana
Gotsens, Mercè
Kovács, Katalin
Mackenbach, Johan
Martikainen, Pekka
Maynou, Laia
Morrison, Joana
Palència, Laia
Pérez, Gloria
Pikhart, Hynek
Rodríguez-Sanz, Maica
Santana, Paula
Saurina, Carme
Tarkiainen, Lasse
Borrell, Carme
author_facet Hoffmann, Rasmus
Borsboom, Gerard
Saez, Marc
Mari Dell’Olmo, Marc
Burström, Bo
Corman, Diana
Costa, Claudia
Deboosere, Patrick
Domínguez-Berjón, M Felicitas
Dzúrová, Dagmar
Gandarillas, Ana
Gotsens, Mercè
Kovács, Katalin
Mackenbach, Johan
Martikainen, Pekka
Maynou, Laia
Morrison, Joana
Palència, Laia
Pérez, Gloria
Pikhart, Hynek
Rodríguez-Sanz, Maica
Santana, Paula
Saurina, Carme
Tarkiainen, Lasse
Borrell, Carme
author_sort Hoffmann, Rasmus
collection PubMed
description BACKGROUND: Health and inequalities in health among inhabitants of European cities are of major importance for European public health and there is great interest in how different health care systems in Europe perform in the reduction of health inequalities. However, evidence on the spatial distribution of cause-specific mortality across neighbourhoods of European cities is scarce. This study presents maps of avoidable mortality in European cities and analyses differences in avoidable mortality between neighbourhoods with different levels of deprivation. METHODS: We determined the level of mortality from 14 avoidable causes of death for each neighbourhood of 15 large cities in different European regions. To address the problems associated with Standardised Mortality Ratios for small areas we smooth them using the Bayesian model proposed by Besag, York and Mollié. Ecological regression analysis was used to assess the association between social deprivation and mortality. RESULTS: Mortality from avoidable causes of death is higher in deprived neighbourhoods and mortality rate ratios between areas with different levels of deprivation differ between gender and cities. In most cases rate ratios are lower among women. While Eastern and Southern European cities show higher levels of avoidable mortality, the association of mortality with social deprivation tends to be higher in Northern and lower in Southern Europe. CONCLUSIONS: There are marked differences in the level of avoidable mortality between neighbourhoods of European cities and the level of avoidable mortality is associated with social deprivation. There is no systematic difference in the magnitude of this association between European cities or regions. Spatial patterns of avoidable mortality across small city areas can point to possible local problems and specific strategies to reduce health inequality which is important for the development of urban areas and the well-being of their inhabitants.
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spelling pubmed-40078072014-05-19 Social differences in avoidable mortality between small areas of 15 European cities: an ecological study Hoffmann, Rasmus Borsboom, Gerard Saez, Marc Mari Dell’Olmo, Marc Burström, Bo Corman, Diana Costa, Claudia Deboosere, Patrick Domínguez-Berjón, M Felicitas Dzúrová, Dagmar Gandarillas, Ana Gotsens, Mercè Kovács, Katalin Mackenbach, Johan Martikainen, Pekka Maynou, Laia Morrison, Joana Palència, Laia Pérez, Gloria Pikhart, Hynek Rodríguez-Sanz, Maica Santana, Paula Saurina, Carme Tarkiainen, Lasse Borrell, Carme Int J Health Geogr Research BACKGROUND: Health and inequalities in health among inhabitants of European cities are of major importance for European public health and there is great interest in how different health care systems in Europe perform in the reduction of health inequalities. However, evidence on the spatial distribution of cause-specific mortality across neighbourhoods of European cities is scarce. This study presents maps of avoidable mortality in European cities and analyses differences in avoidable mortality between neighbourhoods with different levels of deprivation. METHODS: We determined the level of mortality from 14 avoidable causes of death for each neighbourhood of 15 large cities in different European regions. To address the problems associated with Standardised Mortality Ratios for small areas we smooth them using the Bayesian model proposed by Besag, York and Mollié. Ecological regression analysis was used to assess the association between social deprivation and mortality. RESULTS: Mortality from avoidable causes of death is higher in deprived neighbourhoods and mortality rate ratios between areas with different levels of deprivation differ between gender and cities. In most cases rate ratios are lower among women. While Eastern and Southern European cities show higher levels of avoidable mortality, the association of mortality with social deprivation tends to be higher in Northern and lower in Southern Europe. CONCLUSIONS: There are marked differences in the level of avoidable mortality between neighbourhoods of European cities and the level of avoidable mortality is associated with social deprivation. There is no systematic difference in the magnitude of this association between European cities or regions. Spatial patterns of avoidable mortality across small city areas can point to possible local problems and specific strategies to reduce health inequality which is important for the development of urban areas and the well-being of their inhabitants. BioMed Central 2014-03-12 /pmc/articles/PMC4007807/ /pubmed/24618273 http://dx.doi.org/10.1186/1476-072X-13-8 Text en Copyright © 2014 Hoffmann et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Hoffmann, Rasmus
Borsboom, Gerard
Saez, Marc
Mari Dell’Olmo, Marc
Burström, Bo
Corman, Diana
Costa, Claudia
Deboosere, Patrick
Domínguez-Berjón, M Felicitas
Dzúrová, Dagmar
Gandarillas, Ana
Gotsens, Mercè
Kovács, Katalin
Mackenbach, Johan
Martikainen, Pekka
Maynou, Laia
Morrison, Joana
Palència, Laia
Pérez, Gloria
Pikhart, Hynek
Rodríguez-Sanz, Maica
Santana, Paula
Saurina, Carme
Tarkiainen, Lasse
Borrell, Carme
Social differences in avoidable mortality between small areas of 15 European cities: an ecological study
title Social differences in avoidable mortality between small areas of 15 European cities: an ecological study
title_full Social differences in avoidable mortality between small areas of 15 European cities: an ecological study
title_fullStr Social differences in avoidable mortality between small areas of 15 European cities: an ecological study
title_full_unstemmed Social differences in avoidable mortality between small areas of 15 European cities: an ecological study
title_short Social differences in avoidable mortality between small areas of 15 European cities: an ecological study
title_sort social differences in avoidable mortality between small areas of 15 european cities: an ecological study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007807/
https://www.ncbi.nlm.nih.gov/pubmed/24618273
http://dx.doi.org/10.1186/1476-072X-13-8
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